AUSTAT

Parkinson's Disease

Benefits for Parkinson's Disease from Australian Developed Technique

British study (2003) shows Alexander Technique benefits Parkinson's Disease sufferes

A recent British study (2003) shows Alexander Technique lessons improve daily life activities and may reduce rate of medication increase.

Sufferers of Parkinson's Disease are likely to improve their management of everyday activities, and may also delay increases in their Parkinson's Disease (PD) medication, following a series of lessons in the Alexander Technique, concludes a British study from 2003 of over 90 PD subjects.

The Alexander Technique was developed in Australia over 100 years ago by Frederick Matthias Alexander, and concerns the practical relationship between thought and muscle activity in both postural support and movement. In the recently published "Randomised controlled trial of the Alexander Technique for idiopathic Parkinson's disease" (Clinical Rehabilitation 2002; 16:705-718), British researchers examined more closely some hypotheses suggested by an earlier pilot study (Clinical Rehabilitation 1997; 11:8-12).
"While there were indications that, alongside pharmacological therapy, the technique was very beneficial to PD sufferers, we had to test whether the sustained improvement arose from learnt Alexander skills, rather than the therapeutic effects of touch and attention," explains Chloe Stallibrass, one of the authors of the study.

"Because the Alexander Technique (AT) is taught in one-on-one lessons with verbal advice and manual contact, we chose therapeutic massage as the treatment control for the study."

Three groups were formed out of a total of 93 subjects, balanced for age, gender and the duration and severity of their illness. One group received normal treatment only (i.e. medication), another received normal treatment and 24 Alexander Technique lessons over 12 weeks, and the final group received normal treatment and 24 massage sessions over 12 weeks.

Assessments were made before the study, immediately after the 12 week trial period, and six months later. Using the Self-rated Parkinson's Disease Disability Scale (SPDDS), subjects rated 25 separate actions at both their best time of day and their worst time of day.

After Alexander lessons, the AT groups performed everyday activities with less difficulty than the normal treatment only group, both at best and at worst times of day. At the six month follow-up, the comparative improvement was maintained. Immediately after the treatment period, there was no significant improvement in the massage group compared with the normal treatment only group.

As Parkinson's is a progressive disease, performance declined in all groups during the period up to the six month follow-up, but the AT group, unlike the other two groups, were still performing better than at the start of the trial.

In an open-ended questionnaire immediately after the trial, participants in the AT lessons mentioned several specific benefits, including; improved balance/posture (59%), improved walking (48%), improved speech (38%), reduced stress/panic (35%), greater energy/less tired (31%), reduced tremor (28%) and improved self-confidence (28%).

In the massage group, comparable improvements for these same topics rated at 7% or less.

Differences in the rate of medication changes were also noticed during the trial. A higher proportion of non-AT subjects adjusted their PD medication to improve symptoms. At the six month follow-up, those subjects in the non-AT groups who had not adjusted their PD medication, a higher proportion reported worsening symptoms than the subjects in the AT group.

"The clinical messages arising from this trial indicate that a relatively small number of lessons in the Alexander Technique leads to sustained benefits in patients with idiopathic Parkinson's disease", says Chloe Stallibrass. "The sustained benefits are mainly due to acquiring the ability to apply Alexander Technique skills in daily life.

"The possibility that the Alexander Technique could slow the rate of dose increase in levodopa-replacement drugs, or help the patient delay uptake, is worth further research, as are the indications that the Alexander Technique can help with facial expression, speech, and the management of tremor."

Parkinson's Disease affects more than 30,000 Australians.

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